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An unusual case of a giant prolactinoma extending to the nasopharynx and nasal cavity is presented. A 35-year-old man admitted for nasal obstruction and visual disturbances was found to have bilateral anosmia, right homonymous hemianopsia, and a right hemiparesis. The serum prolactin level was 13,300 ng/mL. Radiological examination revealed a large mass invading the skull base and extending into the suprasellar region and the left frontal lobe superiorly and into the nasopharynx inferiorly. Subtotal removal was done through a bilateral orbitofrontal craniotomy, which was followed by radiotherapy and bromocriptine administration. Immunohistochemical analysis confirmed a prolactinoma. The rarity of such a tumor, its location and extension, and the usefulness of magnetic resonance imaging and immunohistochemistry are stressed. Pertinent literature is reviewed.

Although infiltrating angiolipomas are histologically benign, recurrence has been reported in more than 50% of patients after partial extirpation. The authors have treated a 14-year-old female with a large infiltrating angiolipoma of the neck, in whom magnetic resonance imaging was more valuable than x-ray computed tomography and angiography in delineating the extent of the tumor. Total removal of the tumor was performed with the aid of an operating microscope. To our knowledge, this is the first description of the magnetic resonance imaging of an infiltrating angiolipoma. When other neuroradiologic examinations cannot be considered to demonstrate the extent of the tumor accurately, magnetic resonance imaging may be recommended.